Please accept this application along with my annual dues as my request for membership in the CSCA.
Type of Membership you are applying for: (Check one)
|Principal ($300)||Active($40)||Associate ($40)|
|Type of Vendor (if applicable):|
|Applicant’s Signature: ____________________________________________|
(Required ONLY if applying for Active Membership)
As the Coroner or Medical Examiner of County in the State of California, I hereby certify the above applicant meets the requirements for Active Membership in the California State Coroners’ Association.
Fill out the form, , (don’t forget to sign it), then mail it with check payable to CSCA to: